PET DEATH CERTIFICATE

Pet InformatIon
License No. Canine ❍ Pet’s Name Gender Breed Date of Death
Feline ❍
Owner’s Last Name/First Name Email Address (if applicable) Phone No.

Address City Zip Code

VeterInary ClInIC InformatIon

Clinic Name Address Station No.

Veterinarian (Print Name) DVM License No. Phone No.

Signature Date

• Death Certificate is not to be mailed or faxed. Please remit along with the Monthly Accounting Report and vaccine records.
• To view the status/information of any pet account, please log onto our website www.miamidade.gov/animals/ and click on
‘Licenses’ icon followed by “Dog License Look-up.” Enter the most recent dog license number.
• For additional information, please call 3-1-1.
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